Most patients who have been diagnosed with rectal cancer will need some type of surgical procedure to remove the cancerous tissue. For many years, Abdominoperineal resection (APR) was the treatment of choice by colorectal specialists for most patients with rectal cancer. While modern technology has given additional choices for surgical procedures in patients with rectal cancer, APR is still a necessary modality in select patients. Below, we discuss the ins and outs of APR surgery including what it is, how it works, and complications associated with it.